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Thursday, October 27, 2022

Potential new way to deliver gene therapy

 Johns Hopkins Medicine researchers say they have successfully used a cell's natural process for making proteins to "slide" genetic instructions into a cell and produce critical proteins missing from those cells. If further studies verify their proof-of-concept results, the scientists may have a new method for targeting specific cell types for a variety of disorders that could be treated with gene therapies. Such disorders include neurodegenerative diseases that affect the brain, including Alzheimer's disease, forms of blindness and some cancers.

For those looking to develop treatments for diseases where cells lack a specific protein, it's critical to precisely target the cell causing the disease in each structure, such as the brain, to safely kickstart the protein-making process of certain genes, says Seth Blackshaw, Ph.D., professor of neuroscience in the Sol Snyder Department of Neuroscience and member of the Institute for Cell Engineering at the Johns Hopkins University School of Medicine. Therapies that don't precisely target diseased cells can have unintended effects in other healthy cells, he adds.

Two methods currently used to deliver protein-making packages into cells vary widely in their effectiveness in both animal models and people. "We wanted to develop a gene expression delivery tool that's broadly useful in both preclinical and clinical models," says Blackshaw.

One current method of sending biochemical packages involves so-called "mini promoters" that direct the expression, or protein-making process of certain stretches of DNA. Blackshaw says this method often fails to express genes in the right cell type.

Another method, called serotype-mediated gene expression, involves delivering tools that latch on to proteins that stud the surface of certain types of cells. However, Blackshaw says such methods are hit-or-miss in their ability to specifically target only one type of cell, and they often fail to work in people even after successful testing in animal models.

The current proof-of-principle study, described Oct. 1 in Nature Communications, has roots in previous research by Johns Hopkins Assistant Professor of Pathology Jonathan Ling, Ph.D., who published "maps" depicting how various cell types use alternative splicing of messenger RNA, a cousin of DNA, to construct genetic templates that produce an ever-changing set of proteins in the cell. The changes depend on a cell's type and location. Cells normally use alternative splicing to vary the types of proteins a cell can make.

Ling's maps chart the patterns by which cells cut out introns, or extraneous sections of messenger RNA, and leave only the informative parts of genetic material, or exons, that actually express, or make, proteins.

However, introns are normally very large -- sometimes millions of base pairs long and too big to package in currently available gene expression delivery systems. Ling found some 20% of alternative splicing patterns contained sections of intron DNA small enough to package into the gene expression delivery systems Blackshaw wanted to test.

Fortunately, for their purposes, the alternative splicing patterns were similar in both mouse and human DNA, and so potentially, applicable to both preclinical research and clinical use.

Together with then-postdoctoral fellow Alexei Bygrave, now an assistant professor at Tufts University, Blackshaw and Ling made packages of alternative spliced messenger RNA that could be delivered into cells via a benign virus. They dubbed the packages SLED, for splicing-linked expression design.

When the package slides into a cell, it opens there. Because the SLED system is not naturally integrated into the genome, the research team added genetic "promoters" that spark the production of proteins from the packaged SLED product.

The Johns Hopkins Medicine researchers constructed SLED systems for laboratory-cultured excitatory neurons and photoreceptors and were able to produce proteins exclusively in those cell types about half the time. Current minipromoter systems typically get the proteins in the right place about 5% of the time.

The team also injected SLED packages into mice with photoreceptors in the retina that lack a functional PRPH2 gene, which causes retinitis pigmentosa, a disease affecting the retina. The team found evidence that the SLED packages helped produce PRPH2 proteins in the photoreceptors of the treated mice.

In human ocular melanomas cultured in the laboratory, the scientists delivered SLED packages into only melanoma cells that lack the SF3B1 gene. The SLED package released RNA-producing protein that made the melanoma cells die.

Blackshaw says the SLED system's best potential may be in combination with other gene delivery systems, and his lab is looking into methods to miniaturize introns to accommodate larger-size introns into SLED systems.

Blackshaw and Ling have filed for patents that involve SLED technology.

The research was funded by the National Institutes of Health (RF1MH123237, R24EY027283, K08EY027093, R01EY033103, 2T32EY007143), a Stein Innovation Award from Research to Prevent Blindness, the Wilmer Eye Institute, the National Science Foundation, a Johns Hopkins Kavli NDI Fellowship, and a Johns Hopkins IDIES Seed Fund.

Other researchers who contributed to the work include Clayton Santiago, Rogger Carmen-Orozco, Vickie Trinh, Minzhong Yu, Yini Li, Ying Liu, Kyra Bowden, Leighton Duncan, Jeong Han, Kamil Taneja, Rochinelle Dongmo, Travis Babola, Patrick Parker, Lizhi Jiang, Patrick Leavey, Jennifer Smith, Rachel Vistein, Megan Gimmen, Benjamin Dubner, Eric Helmenstine, Patric Teodorescu, Theodoros Karantanos, Gabriel Ghiaur, Patrick Kanold, Dwight Bergles, Ben Langmead, Shuying Sun, Kristina Nielsen, Neal Peachey, Mandeep Singh, W. Brian Dalton, Fatemeh Rajaii and Richard Huganir.


Story Source:

Materials provided by Johns Hopkins MedicineNote: Content may be edited for style and length.


Journal Reference:

  1. Jonathan P. Ling, Alexei M. Bygrave, Clayton P. Santiago, Rogger P. Carmen-Orozco, Vickie T. Trinh, Minzhong Yu, Yini Li, Ying Liu, Kyra D. Bowden, Leighton H. Duncan, Jeong Han, Kamil Taneja, Rochinelle Dongmo, Travis A. Babola, Patrick Parker, Lizhi Jiang, Patrick J. Leavey, Jennifer J. Smith, Rachel Vistein, Megan Y. Gimmen, Benjamin Dubner, Eric Helmenstine, Patric Teodorescu, Theodoros Karantanos, Gabriel Ghiaur, Patrick O. Kanold, Dwight Bergles, Ben Langmead, Shuying Sun, Kristina J. Nielsen, Neal Peachey, Mandeep S. Singh, W. Brian Dalton, Fatemeh Rajaii, Richard L. Huganir, Seth Blackshaw. Cell-specific regulation of gene expression using splicing-dependent frameshiftingNature Communications, 2022; 13 (1) DOI: 10.1038/s41467-022-33523-2

Edwards Plummets After Slashing Profit Guidance As Challenges Mount In U.S

Edwards Lifesciences (EW) slashed its profit outlook Thursday, leading EW stock to plummet amid continued hospital staffing and exchange-rate challenges.

In late trading on today's stock market, EW stock tumbled 7.3% near 80. During the regular session, shares lost 0.5%, closing at 86.30.

For the year, the maker of heart products now expects to earn $2.40-$2.50 per share, down from its prior outlook for $2.50-$2.65. Edwards noted that's still above 2021 levels. On a year-over-year basis, adjusted earnings would climb more than 10%. The company also expects sales to come in at the low end of its guidance for $5.35 billion to $5.55 billion.

"The company anticipates that the U.S. hospital staffing challenge and strong U.S. dollar are likely to persist and now expects total company sales for 2022 at the low end of its previous range," the company said in a news release.

EW Stock: Exchange Rates Weigh On Sales

The guidance cut follows a third-quarter disappointment. Sales grew 1% to $1.32 billion but just missed expectations for $1.33 billion, according to EW stock analysts polled by FactSet. In constant currency, sales grew a stronger 7%.

Earnings advanced 13% to 61 cents per share. But that was a penny under expectations. Edwards noted adjusted earnings took a 7-cent hit after the company discontinued a mitral valve program called Harpoon. The mitral valve is a part of the heart that can become faulty, requiring repair.

Overall, sales of transcatheter aortic heart-valve replacements, or TAVR, rose 1% to $862 million. TAVR is a method of replacing a diseased heart valve without resorting to open-heart surgery. Excluding the impact of exchange rates, sales climbed 6%.

Meanwhile, surgical sales increased 1% to $220 million. In constant currency, those sales rose 8%. Edwards also reported $30 million in sales from its transcatheter mitral and tricuspid therapies. These products treat other valve problems in the heart and don't require surgery.

https://www.investors.com/news/technology/ew-stock-edwards-earnings-q3-2022/

Biden clocks 118 mph but loses drag race against Colin Powell’s son on ‘Jay Leno’s Garage’

 President Biden zoomed behind the wheel of a classic Corvette, hitting 118 mph as he competed in a drag race in an episode of “Jay Leno’s Garage” that aired Wednesday night.

Biden, 79, packed into a 1967 Corvette Stingray with a 350 horsepower, a classic car that was a wedding gift from his father.

“I was getting married in August of ’67. My dad didn’t have a lot of money but he ran the largest Chevrolet dealership in the state for years,” he said. “So, there’s 75 people outside the dealership. We pull up, they spread. My dad says, ‘This is my wedding gift.'”

Biden buckled in for the race at a Secret Service training facility in Beltsville, Md., against Michael Powell, the son of former Secretary of State Colin Powell.

Powell, behind the wheel of a 2015 Corvette Stingray with 455 horsepower, had a slight advantage against the president after beating him off the line.

But Biden hung in close as he clocked in at 118 mph, coming in not far behind Powell as they rolled to a stop.

“I am in so much trouble,” Leno joked after Biden completed the race. “Uh oh, here comes the Secret Service.”

Powell’s victory settles a score between Biden and the late Colin Powell after they raced against each other in season two of “Jay Leno’s Garage.” The 2016 drag race ended in a Biden win.

Biden, a known car enthusiast, appeared on the CNBC show to promote electric vehicles (EVs), which were a major part of the Inflation Reduction Act passed in August.

The legislation includes new incentives to encourage the use of EVs, with the federal government rolling out more charging stations and tax credits for the purchase of the eco-friendly cars.

Biden also drove an electrified 1978 Ford F100 truck, which he said was “quiet as hell” and smooth to drive.

The president also discussed the importance of EVs, calling it an “answer” to the financial security of automobile companies and a chance to do “something good.”

“This is the only time you get to drive,” Leno remarked.

“Yeah, it is,” Biden replied. “It’s the God’s truth, and I miss it.”

https://thehill.com/blogs/in-the-know/3708012-biden-clocks-118-mph-but-loses-drag-race-against-colin-powells-son-on-jay-lenos-garage/

People of color much less likely to receive Paxlovid, other COVID treatments: CDC data

 People of color with a COVID-19 diagnosis were much less likely to receive Paxlovid and other treatments than white patients, according to new data from the Centers for Disease Control and Prevention (CDC).

The findings are consistent across all age groups and underscore the persistent disparities surrounding access to COVID-19 treatments, especially the antiviral pill Paxlovid. Paxlovid is the most commonly prescribed medication and the preferred outpatient therapeutic for eligible patients, according to the CDC.

Paxlovid is available primarily for people who test positive for COVID-19 and are at high risk of developing serious illness, such as the immunocompromised or older patients. It’s taken at home, and has been shown to significantly reduce hospitalization and death. 

During a four-month period from April to July 2022, Paxlovid treatment was 36 percent lower among Black patients relative to White patients and 30 percent lower among Hispanic patients relative to non-Hispanic patients.

The largest difference was between Black and White patients aged 65 to 79, where white patients were 44 percent more likely to receive a Paxlovid prescription.

The study found disparities in other treatments — including antivirals molnupiravir and remdesivir, as well as the monoclonal antibody bebtelovimab — but they were much less frequently prescribed than Paxlovid.

The study did not assess why the disparities were so striking, but researchers suggested multiple factors, including that people living in counties that are both high-poverty areas and majority minority are less likely to have access to COVID-19 treatment facilities.

In addition, minority patients’ previous negative experiences with health care services could influence their decisions regarding use of treatments, or racism and implicit biases among health care providers might also have contributed to treatment disparities.

Paxlovid is only available by prescription, and must be taken within five days of a patient first showing symptoms. That compressed timeline can make it difficult for patients to access it in a timely manner.

A number of states and cities have launched free “Test-to-Treat” programs, an initiative the federal government launched in May to help build equitable access to COVID-19 treatments. The program allows people with COVID-19 symptoms to get tested, be prescribed antiviral pills, and fill the prescription all in one visit. 

But if a patient’s community doesn’t have such a program, then a doctor’s appointment is still needed in order to get a prescription, which can take time and money many low-income minority patients don’t have.  

Equity is especially important as the federal government moves to end federal purchase and distribution of vaccines and treatment, shifting it all to the commercial marketplace. 

According to a recent  Kaiser Family Foundation analysis, the commercialization of COVID-19 treatments, tests and vaccines would create substantial access barriers for the uninsured and underinsured unless the government builds in protections.

https://thehill.com/policy/healthcare/3708378-cdc-data-people-of-color-much-less-likely-to-receive-paxlovid-other-covid-treatments/

Disney features first plus-sized heroine in short film

 Disney premiered its first plus-sized protagonist in a new short film called “Reflect.” 

The minutes-long film promotes body positivity and self-acceptance as the heroine, Bianca, comes to terms with her own reflection during a ballet class.  

The short began streaming on Disney+ on Sept. 14 and is episode six of season two of “Short Circuit,” a series of short films produced by Walt Disney Animation Studios.  

“Reflect” begins with the young dancer pirouetting, joyfully gasping after she successfully completes the rotation.  

While doing warm up exercises next to a mirror-lined wall, Bianca keeps her head down, looking away from her own reflection.  

Her instructor eventually forces her to look at herself in the mirror after telling her “tight tummy, long neck.” And as Bianca looks at herself in the mirror, gently pressing on her stomach to make it seem smaller, the room goes black, and the glass starts to break.  

“The idea for the short began thinking about my own body philosophy,” said Hillary Bradfield, director of “Reflect.” “I feel that I am a very body positive person in principle, but when it’s on a personal level it’s a lot harder to be body positive.” 

In an interview on Disney+, Bradfield said telling a body positivity story from a dancer’s perspective seemed “natural” since it is typical for dancers to work in rooms surrounded by their own reflection to see their posture and movement.  

“When people watch the short I hope that they can feel more positively about themselves and how they look,” Bradfield said.  

https://thehill.com/changing-america/enrichment/arts-culture/3708354-disney-features-first-plus-sized-heroine-in-short-film/

Vertex Shrugs Off Regular-Session Malaise As International Sales Drive Quarterly Beat

 Vertex Pharmaceuticals (VRTX) beat third-quarter expectations Thursday, helping VRTX stock shrug off some of the malaise that plagued it during the regular session.

In after-hours trading on today's stock market, VRTX stock advanced roughly 2% and was trading near 293.50. Shares fell about 7.5% during the regular session. It was unclear what drove the dive, though it could possibly be related to an upcoming presentation from 4D Molecular Therapeutics (FDMT) for a cystic fibrosis treatment.

Today, Vertex is the de facto leader of the cystic fibrosis market. During the quarter ended Sept. 30, the company's suite of medicines generated $2.33 billion in third-quarter sales. On a year-over-year basis, sales climbed 18% and beat forecasts for $2.23 billion.

The best growth came from the international segment, where $879 million in sales beat expectations for $760 million, RBC Capital Markets analyst Brian Abrahams said in a report to clients. He noted reimbursement is improving in international markets, helping sales spike higher. He has a sector perform rating on VRTX stock.

VRTX Stock: Trikafta Cannibalization Continues

Vertex's newest medicine, Trikafta, was the only of its four cystic fibrosis products to grow. Trikafta can treat roughly nine in 10 patients with the lung disease, so many patients are switching from Vertex's older medicines to its newest drug. Trikafta sales rocketed 29% to $2.01 billion.

Meanwhile, adjusted profit also notched a quarterly beat, rising 14% to $4.01 per share. Analysts called for earnings of $3.61 a share.

"The third quarter marked another period of strong performance in the (cystic fibrosis) business and across the company," Chief Executive Reshma Kewalramani said in a written statement.

But competition could be coming in cystic fibrosis. 4D Molecular is working on an aerosol treatment for the disease. That drug is currently in Phase 1 and Phase 2 testing. The company is also working on heart and eye disease treatments.

Vertex Raises Sales Outlook For 2022

Still, Vertex raised its guidance for the year. Now, the company expects its product sales — which discounts revenue from royalties and collaboration agreements — to grow 16% to a midpoint of $8.85 billion. Previously, the company guided to $8.6 billion to $8.8 billion in full-year sales.

"Despite some concerns about (cystic fibrosis) franchise maturity based on slowing prescription growth which we shared, international growth demonstrated that the core business still has some legs," RBC's Abrahams said.

VRTX stock analysts forecast adjusted profit of $14.14 per share and $8.79 billion in sales. The firm didn't offer an earnings outlook.

Next, investors are looking for Vertex and Crispr Therapeutics (CRSP) to file for Food and Drug Administration approval of a CRISPR gene therapy-based treatment for sickle cell disease and beta thalassemia, both blood disorders.

The companies say they plan to begin submitting data to the FDA in November and expect to complete their submission by the end of the first quarter.

https://www.investors.com/news/technology/vrtx-stock-vertex-earnings-q3-2022/

Inovio Halts Development on COVID-19 Heterologous Booster Vaccine Candidate

 INOVIO (NASDAQ:INO), a biotechnology company focused on developing and commercializing DNA medicines to help treat and prevent infectious diseases, cancer, and diseases associated with HPV, today announced that it has discontinued its internally funded efforts to develop INO-4800 as a COVID-19 heterologous booster vaccine. The decision follows INOVIO's comprehensive review of its portfolio, market conditions, and global demand for COVID-19 vaccines.

Dr. Jacqueline Shea, INOVIO's CEO and President, stated: "We continue to believe that our DNA medicine technology has attributes that could be beneficial to a heterologous COVID-19 booster vaccine. However, our assessment of the current global demand for COVID-19 vaccines, changes in regulatory timelines and requirements, diminishing government financial support, and the overall growing uncertainty related to opportunities for heterologous booster vaccines have resulted in our decision to discontinue internal funding efforts to develop INO-4800 as a heterologous booster vaccine. As we work to bring DNA medicines to the marketplace, we will reallocate resources and focus our efforts on other product candidates in our pipeline, such as INO-3107 and INO-5401, both of which recently reported positive Phase 1/2 data for their respective targeted indications in recurrent respiratory papillomatosis and glioblastoma. We continue to expect to be able to report updates in the coming months from our other ongoing trials targeting Cervical High-Grade Squamous Intraepithelial Lesions (REVEAL 2), Ebola, Lassa fever and MERS."

https://finance.yahoo.com/news/inovio-provides-covid-19-heterologous-203000015.html